Understanding Prescription Drug Abuse

What are Prescription Drugs?

The Food and Drug Administration defines prescription medications as substances intended to diagnose, cure, mitigate, treat, or prevent disease. This can include mental illnesses, including anxiety and depression, among many others. A person’s doctor may also prescribe medicines to treat physical conditions such as chronic pain, high or low blood pressure, migraines, and much more. Misusing medications, whether or not they are prescribed, can lead to harmful mental and physical effects, and even worse, it could even lead to death.

Commonly Abused Prescription Drugs

While any prescription drug can be misused, there are three types of medications that are commonly abused: opioids, central nervous system (CNS) depressants, and stimulants. 

Prescription Opioid Abuse

Opioids are commonly abused prescription drugs typically used to treat pain and are often referred to as pain medicine or painkillers. These are synthetic drugs, similar to opiates, which are derived from a natural poppy plant. These drugs attach to opioid receptors in the central nervous system and other parts of the body. This blocks the pain signals the brain sends to the body and also releases large amounts of dopamine, the neurotransmitter involved in pleasure and reward. Increased levels of dopamine lead the person to continue to take the drugs to feel that same amount of pleasure.

Sedative or CNS Depressants Abuse

CNS depressants are sedative-hypnotic drugs that are prescribed to treat anxiety and sleep disorders such as insomnia, seizures, and muscle spasms. These drugs include barbiturates and benzodiazepines (benzos).  Overall, these drugs slow down the brain by enhancing the effects of GABA transmission, a neurotransmitter whose purpose is to decrease excitation in the brain and body, which can help ease a medical condition like anxiety or help a person sleep.

Prescription Stimulant Abuse

Stimulants are drugs that have the opposite effect of CNS depressants – they speed up brain processes or make them more efficient. These medications are often prescribed to treat attention deficit hyperactivity disorder (ADHD), narcolepsy, and obesity.  If taken according to a provider’s instructions, stimulant medication can really help improve the quality of life for those with such conditions.

Behavioral Symptoms of Prescription Drug Abuse

Prescription abuse can lead to a risk of behavioral changes. Many of these behavioral changes in patients who abuse prescription drugs can also be signs of addiction. Prescription drug misuse can lead to the patient developing a substance use disorder (SUD), which is the clinical term for a drug addiction. Some changes in behavior that one may notice can include one or all of the following.

• Forging, stealing, or selling prescriptions

• Taking higher doses than prescribed

• Being hostile or having mood swings

• Sleeping less or more

• Making poor decisions

• Being unusually energetic, high, or revved up

• Being drowsy

• Requesting early refills or continually “losing” prescriptions, so more prescriptions must be written

• Trying to get prescriptions from more than one prescriber

According to the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM-5-TR), a person must display at least two of these criteria in the past 12 months to be diagnosed with an SUD:

• Taking the substance in greater doses or for longer than they intended.

• Wanting to cut down or stop using the substance but are unable to.

• Spending a great deal of their time getting, using, or recovering from the substance.

• Craving the substance.

• Unable to complete tasks at school or work as a result of the substance use.

• Continuing to use the substance even when it causes problems within their relationships.

• Giving up important work, social, and recreational activities due to substance use.

• They repeatedly use the substance in dangerous situations.

• They continue to use when their physical or mental health declines as a result of the substance use.

• More of the substance is required to get the desired effect. In other words, they’ve built a tolerance to the substance.

• Experiencing withdrawal symptoms when not taking the substance, and they can only relieve their symptoms by taking more of the substance.

Other Consequences and Dangers of Prescription Drug Abuse

Because we can see how prescription drug misuse can change the behavior of an individual, it is important to understand there are other dangers to prescription drug addiction. Drug abuse can impair a person’s judgment, which can lead to making risky decisions that may affect their health or the safety of others.

Impaired Driving or Equipment Operation: Many prescription drugs, particularly opioids and sedatives, can impair cognitive functions, reaction time, and motor skills, increasing the likelihood of accidents when individuals drive or operate machinery under the influence.

Increased Crime Rates: Prescription drug abuse is often linked to theft, fraud (e.g., “doctor shopping” or forging prescriptions), and other criminal activities. People struggling with addiction may engage in illegal activities to obtain more drugs.

Spread of Infectious Diseases: When prescription drugs like opioids are injected, using and sharing unsterile needles can spread bloodborne diseases like HIV and hepatitis. Drug use is also linked to risky intimate behavior, which could lead to the contraction of sexually transmitted diseases.

Impact on Emergency Services: Prescription drug misuse can strain first responders, emergency medical services, and hospitals, including an increase in emergency room visits for overdose treatment and complications.

Danger to Children: Accidental ingestion of prescription drugs by children or exposure to drugs while pregnant can cause serious health complications, developmental issues, or neonatal withdrawal syndromes.

Risk Factors of Prescription Drug Abuse

Opioids, depressants, and stimulants can cause physical dependence and addiction, regardless of whether a doctor prescribes them or not. Some people may try combining one drug with another to get a specific type of high or try to cancel out side effects. This is a highly dangerous activity. Combining prescription medications with other medications, illicit drugs, or alcohol can lead to serious side effects, cause overdose, and, in some instances, can be fatal.

Some risk factors may increase an individual’s likelihood of becoming addicted to a prescription drug, including:

• Gender:  Studies indicate that women tend to be more likely to misuse a prescription drug by taking high doses to relieve pain.

• Physical health problems: Individuals with chronic pain or fatigue.

• Mental health disorders: People with depression, anxiety, post-traumatic stress disorder (PTSD), and other mental health problems may be more at risk of misusing prescription drugs because they are trying to self-medicate their symptoms.  

• History of substance misuse: Studies suggest previous struggles with substance use are linked to the misuse of prescription medications.

• Age: Older adults (65 and older) and younger adults (those 18-25) are both at a higher risk of misusing medication.

• Taking medications for a prolonged duration: Taking prescription opioids and benzodiazepines for an extended period creates tolerance and a significant risk for using in higher doses or more often, which can lead to addiction or other negative consequences.

Treatment for Prescription Drug Addiction

If you or a loved one is struggling with prescription drug abuse, it’s important to seek help. Prescription drug addiction, whether it involves opioids, stimulants, or benzodiazepines, is a complex condition with physical and psychological dependencies. Overcoming this addiction often requires professional help and a comprehensive treatment plan.

Treatment options for prescription drug abuse may include:

Detoxification: In cases where withdrawal symptoms are severe, medically supervised detoxification can safely manage the withdrawal process and prepare you for further treatment.

Residential Addiction Treatment: Intensive residential rehab programs provide a structured, supportive environment where you can focus solely on your recovery with 24/7 care and comprehensive therapy.

Behavioral Therapy: These therapies can help you understand your addiction, develop coping mechanisms, and modify unhealthy behaviors. They include cognitive behavior therapy (CBT) and dialectical behavior therapy (DBT) .

Medication-Assisted Treatment (MAT): For opioid addiction, MAT uses medications like methadone, buprenorphine, and naltrexone to manage withdrawal symptoms, reduce cravings, and prevent relapse.

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